You have it correct: if the patient meets criteria for septic shock with SIRS 
criteria, Sepsis, and Severe Sepsis and has a lactic acid >4, that patient will 
code as septic shock even if the provider does not document it.

Sean R. Townsend, M.D.
Vice President of Quality & Safety
California Pacific Medical Center
2330 Clay Street, #301
San Francisco, CA  94115
email [email protected]<mailto:[email protected]>
office (415) 600-5770
fax (415) 600-1541

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of [email protected]
Sent: Tuesday, October 06, 2015 9:04 AM
To: [email protected]
Subject: [Sepsis Groups] coding

So, just need clarification....if the patient meets criteria for septic shock 
with SIRS criteria, Sepsis, and Severe Sepsis and has a lactic acid >4, that 
patient will code as septic shock even if the provider does not document it??  
The guidelines say septic shock is hypotension unresponsive to fluids AND/OR 
lactic acid >4.  But, many of our physicians are resistant to the lactic acid, 
stating it can be elevated for many other reasons besides sepsis.

Thank you,
Debbie

Debbie Chambless, MSN, RN, ARNP-C
Sepsis Coordinator
Osceola Regional Medical Center
Kissimmee, Fl 34741
Office: 407-518-3949
Cell: 772-807-0525

~~Recognizing sepsis as a global enemy.  Hoping for global unity in finding a 
solution~~

[cid:[email protected]]

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